Navneet Puri

Intravenous emulsified halogenated anesthetics produce acute and delayed preconditioning against myocardial infarction in rabbits.

Background:Preconditioning against myocardial infarction by volatile anesthetics is well known. The authors tested the hypothesis that new emulsified formulations of halogenated anesthetics administered intravenously reduce myocardial infarct size when administered either 1 or 24 h before prolonged ischemia and reperfusion. Methods:Pentobarbital-anesthetized rabbits (n = 39) were instrumented for measurement of hemodynamics and randomly assigned to receive intravenous saline (control), lipid vehicle, or infusions (3.5 ml · kg−1 · h−1 for 30 min) of emulsified isoflurane (6.9%), enflurane (7.1%), or sevoflurane (7.5%). Infusions were discontinued 30 min before a 30-min coronary occlusion and 3 h of reperfusion. In three additional groups, conscious rabbits (n = 21) received saline, lipid vehicle, or emulsified sevoflurane (7.5%) infusions (3.5 ml · kg−1 · h−1 for 30 min) 24 h before ischemia and reperfusion. Infarct size was determined using triphenyltetrazolium staining. Results:Lipid vehicle produced transient increases in heart rate, whereas emulsified volatile anesthetics had no effect on hemodynamics before coronary occlusion. Lipid vehicle did not affect infarct size (38 ± 2% of the area at risk; mean ± SEM) as compared with saline control (41 ± 4%). In contrast, emulsified isoflurane, enflurane, and sevoflurane reduced infarct size (20 ± 3%, 20 ± 3%, and 21 ± 2% of the area at risk, respectively; P < 0.05). Administration of lipid vehicle or emulsified sevoflurane did not produce sedation or respiratory depression in conscious rabbits. Emulsified sevoflurane (18 ± 2%) but not lipid vehicle (44 ± 2%) reduced infarct size as compared with control in delayed preconditioning experiments. Conclusions:Intravenous emulsified halogenated anesthetics produce acute and delayed preconditioning against myocardial infarction.